Keloidectomy with core fillet flap and intralesional verapamil injection is a reliable and cost-effective method in the treatment of recurrent earlobe keloids with a low rate of recurrence and high patient satisfaction.

Background:Progressive macular hypomelanosis (PMH) is a disease of unclear etiology. Propionbacterium acnes (P. acnes) was claimed to be an etiological factor.Objectives:The purpose of this study was to document the clinicopathological features of PMH in Egyptian patients and to evaluate the therapeutic outcome.Methods:Patients with clinical features of PMH were recruited. Wood’s lamp examination, skin scrapings for fungi, and skin biopsy specimens were obtained. Biopsies were stained with hematoxylin and eosin, PAS, Fontana-Masson, and S100 protein. Patients received either narrow-band UVB (nbUVB) or nbUVB plus daily topical clindamycin 1% and benzoyl peroxide gel 5% (bcUVB). The period of active treatment was 14 weeks followed by a follow-up period of 24 weeks.Results:Twenty-nine patients were included. Microscopic evaluation of skin biopsy specimens showed no significant differences between lesional and normal skin. Fontana-Masson stained sections showed overall reduction of melanin granules in the basal layer of lesional skin only and S100 staining did not detect significant differences in the number of melanocytes in lesional and normal skin. Nearly complete repigmentation was reported in 10 patients treated with bcUVB compared to 9 patients treated with nbUVb with no significant differences between both groups after 14 weeks. Only 2 patients in each group retained the pigmentation and the remaining patients returned to the baseline color before treatment.Conclusions:This study documented the clinicopathological features of PMH among Egyptians. No permanently effective treatment is available. Further studies are needed to prove or disprove the pathogenic role of P. acnes in PMH.

This trial aimed to assess the efficacy of on‐demand oral dapoxetine versus topical lidocaine treatments for lifelong PE. Cases with lifelong PE were randomised to start treatment by oral dapoxetine 60 mg or topical lidocaine 10% spray. The intravaginal ejaculatory latency time (ILET), validated Arabic Index for PE (AIPE), Sexual Health Inventory for Men (SHIM) and frequency of intercourse/week were recorded at the baseline and after 12 weeks treatment period of the first medication before two weeks washout period and then crossing over to the other one for another 12 weeks. Results showed that both medications significantly increased both IELT and AIPE scores compared with the baseline being significantly better with topical lidocaine (63.44 s, 179.4 s versus 21.87 s, p < .05). Significant decrease of SHIM score was recorded with lidocaine but not with dapoxetine. Global Efficacy Question for the patient's assessment of the effectiveness of drugs showed that lidocaine was described as being effective by 43 cases and ineffective by 12 cases, oral dapoxetine was described as being effective by 16 cases and ineffective by 39 cases. From these accumulated data, it is concluded that topical lidocaine is more effective on‐demand therapy for lifelong PE compared with oral dapoxetine.

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Background: The association between endocrine control and ejaculatory reflex is still not completely elucidated. Serum dihydrotestosterone (DHT) concentrations have been reported to be lower in premature ejaculation (PE) patients. We hypothesized that homeostasis between testosterone (T) and their metabolites; dihydrotestosterone (DHT) and estradiol (E2); could be involved in orchestration of the ejaculatory process. Aim: To test this hypothesis, we aimed to investigate any possible relationship between DHT/ E2 ratio and T/E2 ratio in a cohort of patients consulting for premature ejaculation (PE). Methods: This prospective hospital-based cross-sectional case-control study has been carried on 104 PE patients (30 patients with primary lifelong PE and 74 patients with acquired PE) compared to 90 healthy men as controls. Results: DHT levels were significantly higher in secondary PE compared to primary PE group (p = 0.011). Besides, serum E2 showed significant higher level among both primary and secondary PE groups compared to the control group (p=0.001). Moreover, both total testosterone (TT)/E2 and DHT/E2 ratios were significantly lower in both primary and secondary PE compared to the control group (p=0.001 for both). Furthermore, DHT/E2 ratio showed fair discriminating ability between PE and healthy controls (AUC = 0.749, p=0.001). Conclusions: Both TT/E2 and DHT/E2 ratios were significantly lower in both primary and secondary PE subjects suggesting a role of hormonal imbalance in this context. Although this link seems likely, large-scale studies are needed to confirm these findings.

Background: Male urogenital tract infection is one of the most important causes of male infertility worldwide. Infection processes may lead to impairment of sperm quality, and obstruction of the seminal tract. On the light of this, there is a need to institute a microbiological intervention to detect the probable causative microbial agents. Objective: The aim of the work was to detect the common bacteria causing pyospermia in a cross-section of infertile men and the sensitive antimicrobials against these bacteria. Patients and methods: This study included 205 infertile men who were recruited from the outpatient clinic,